Effects of nurse-led telephone-based supportive interventions for patients with cancer: A meta-analysis

Problem Identifcation: To evaluate the effects of nurse-led telephone-based supportive interventions (NTSIs) for patients with cancer. Literature Search: Electronic databases, including EMBASE®, MEDLINE, Google Scholar, Cochrane Library CENTRAL, ProQuest Medical Library, and CINAHL®, were searched through February 2016. Data Evaluation: 239 studies were identifed; 16 were suitable for meta-analysis. Cochrane's risk of bias tool and the Comprehensive Meta-Analysis software were used. Synthesis: The authors performed a meta-analysis of 16 trials that met eligibility criteria. Thirteen randomized, controlled trials (RCTs) and three non-RCTs examined a total of 2,912 patients with cancer. Patients who received NTSIs were compared with those who received attentional control or usual care (no intervention). Conclusions: Telephone interventions delivered by a nurse in an oncology care setting reduced cancer symptoms with a moderate effect size (ES) (-0.33) and emotional distress with a small ES (-0.12), and improved self-care with a large ES (0.64) and health-related quality of life (HRQOL) with a small ES (0.3). Subgroup analyses indicated that the signifcant effects of NTSIs on cancer symptoms, emotional distress, and HRQOL were larger for studies that combined an application of a theoretical framework, had a control group given usual care, and used an RTC design. Implications for Research: The fndings suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confrm the effcacy of NTSI for adoption of specifc care models.